1607. Impact of Multiplex Polymerase Chain Reaction Testing for Respiratory Pathogen Detection in Pediatric Patients 
Session: Poster Abstract Session: Stewardship: Pediatric Antimicrobial Stewardship
Friday, October 6, 2017
Room: Poster Hall CD
Posters
  • Impact of RP PCR in Pediatric Population- IDWeek 2017 Final.pdf (702.5 kB)
  • Background:

    Viral pathogens are a leading cause of respiratory infection in the pediatric population. In August 2015, Williamson Medical Center implemented a respiratory panel (RP) that enables rapid detection of 20 common pathogens by multiplex polymerase chain reaction. Utilization of the RP was reviewed to assess the impact of the test on healthcare and antimicrobial utilization.

    Methods:

    A retrospective chart review was conducted of all patients aged 0 to 17 years with RP specimens collected August 2015 through December 2016. An evaluation of the impact of RP results was completed through review of duration or change in antimicrobial therapy, change in patient management, and avoidance of further workup, antimicrobial therapy, or hospital admission. A subgroup analysis was performed for patients less than 60 days of age.

    Results:

    Two hundred ninety five pediatric patients had a RP specimen collected during the evaluation timeframe. Ninety-six percent of tests were appropriate based on symptoms and 49% of RP results changed patient management (Table 1). RP result did not change management in any patients greater than 10 years of age. A pathogen was identified in 66% of specimens, with rhinovirus/enterovirus (53.6%) and respiratory syncytial virus (20.5%) being the most common viruses isolated. Use of the RP was highest in the months of August through December, with viral pathogen isolation being highest in these months as well. In patients less than 60 days of age (n=40), the RP result changed management in 22 (55%) cases, including 3 avoided admissions, 12 avoided antibiotic courses, and 7 avoided lumbar punctures.

    Table 1: Respiratory Panel Collection 0-17 Years of Age

    Samples Collected

    295

    Test Appropriate Based on Symptoms

    284 (96%)

    Pathogen Detected

    196 (66%)

    Result Changed Management

    145 (49%)

    Avoid Admission

    44

    Reduce Further Procedures/Workup

    33

    Avoid Antibiotics

    89

    Narrow/Decrease Antibiotic Duration

    20

    Target Antimicrobial Therapy

    14

    Conclusion:

    The use of a RP was beneficial in this pediatric population to decrease hospital admissions, avoid further unnecessary procedures, avoid unnecessary antibiotic therapy, decrease duration of antibiotics and target antimicrobial therapy. Further consideration should be given to implement an algorithm for use.

    Courtney C. Sutton, PharmD, BCPPS1, Patti J. Walton, MHSA, MT(ASCP)2, Montgomery F. Williams, PharmD, BCPS1,3, Tracey L. Bastian, PharmD1, Michael Wright, PharmD, BCPS, BCCCP1 and S. Shaefer Spires, MD4,5, (1)Department of Pharmacy, Williamson Medical Center, Franklin, TN, (2)Department of Pathology, Williamson Medical Center, Franklin, TN, (3)Department of Pharmacy Practice, Belmont University College of Pharmacy, Nashville, TN, (4)Department of Medicine, Division of Infectious Diseases, Vanderbilt University Medical Center, Nashville, TN, (5)Department of Medicine, Division of Infectious Diseases, Williamson Medical Center, Franklin, TN

    Disclosures:

    C. C. Sutton, None

    P. J. Walton, None

    M. F. Williams, BioFire Diagnostics: Consultant , Speaker honorarium
    Joint Commission Resources: Consultant , Speaker honorarium

    T. L. Bastian, None

    M. Wright, None

    S. S. Spires, None

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